New Patient Registration
Queenan Family Medicine and Maternity care is unable to accept new patient registrations at this time with the exception of women presenting for prenatal care and household family members of existing patients with the practice.
To register as a new patient with Queenan Family Medicine and Maternity Care, please complete the following steps:
1. Fill out the registration form below, and Dr. Queenan will send you a confirmation email within 2-3 days. If you do not recieve a confirmation email within this time peroid please call 888.494.3064.
2. Once you have filled out the new patient registration, you will be contacted by the nurse within 3 business days to schedule your first appointment. If for some reason you do not hear back, please follow-up with a phone call to 888-494-3064.
3. Then, please complete the following forms prior to your first appointment:
A. Please click here New Patient Questionnaire to complete this health history questionnaire in its entirety in order to maximize our time together in your first visit. If you do not have convenient access to the internet, please download, print, and fill out the printable version of the secure New Patient Questionnaire below and bring it to your first appointment. Your answers to this questionnaire are confidential and will not be shared. Please try to provide as much detail as possible. Thank you for your time.
Download printable New Patient Questionnaire here
B. Thoroughly review the Office Policies and HIPAA Privacy Policy for the practice. Please contact Dr. Queenan with any questions or concerns about these policies. When you are comfortable with these policies, please download, print, and sign the Signature Page with e-mail policy below, and bring this with you to your first appointment.
C. Please download, print, sign, and send the Medical Record Release form below to any provider who has medical records of yours that you would like Dr. Queenan to be able to review for your care, including your former primary care doctor.
Important: You may want to inquire about fees associated with a record transfer. If costs are prohibitive, please contact Dr. Queenan to determine which elements of your medical record are most valuable. Records received by Dr. Queenan can be returned to you after processing if desired.
D. Please download, print, and sign the Rochester RHIO Consent Form. The Rochester RHIO is a secure electronic health information exchange that gives authorized medical providers access to test results, lab reports, radiology results, medication history, insurance eligibility and more. For more information, please click here.
E. If you are registering a child ages 12-17, and you would like to allow your child to be able to access medical care without the physical presence of you (or another legal guardian), please download, print, fill-out, and sign the Consent for Treatment of Child/Minor.
4. Health insurance/payment issues:
Dr. Queenan is a provider with the following health insurers and plans: Aetna, Excellus Health Plans - Blue Cross Blue Shield (which includes the federally financed programs administered by Monroe Plan), MVP Healthcare, and Medicare; while she is contracted with United Health Care, she can unfortunately no longer accept new patients with this insurance; she also accepts self-payment for fee-for-service. If you have any questions regarding whether Dr. Queenan participates with your insurance, please contact her.
If required by your insurance company, be sure to designate Dr. Queenan as your Primary Care Provider in order to make sure that your visit will be appropriately covered.
For patients without health insurance, Dr. Queenan offers discounts for prompt payment; please contact her for further details. Credit card, Debit card, cash, and check are accepted.
If you have any questions, please contact Dr. Queenan by phone (888.494.3064) or email.